Radiographic anatomy of the first metatarsal

Ra, Christman; P, Ly

doi:10.7547/87507315-80-4-177

Cited by 7 publications

(4 citation statements)

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“…This can avoid damage to the tendon insertion, which is approximately 8 mm distal to the first tarsometatarsal joint. 9 We believed that the key was to avoid introduction of the instrument pointing directly at the tendon insertion. It should not be a matter of concern whether the instrument is inserted proximal or distal to the tendon.…”

Section: Discussionmentioning

confidence: 99%

Peroneus Longus Tendoscopy at the Sole: A Cadaveric Study

Lui¹,

Mak²

2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Discussionmentioning

confidence: 99%

Peroneus Longus Tendoscopy at the Sole: A Cadaveric Study

Lui¹,

Mak²

2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…1 The plantar-medial portal is at the plantar-lateral side of the base of the first metatarsal, which is about 1 to 1.5 cm from the first tarsometatarsal joint. The distally placed portal avoids injury to the insertion of the PL tendon at the base of the first metatarsal and medial cuneiform.…”

Section: Techniquementioning

confidence: 99%

“…The PL tendon inserts onto the tuberosity located at the inferolateral corner of the base of the first metatarsal, which is approximately 8 mm from the edge of the articular surface. 1 The plantar-medial portal is at the plantar-lateral side of the base of the first metatarsal, which is about 1 to 1.5 cm from the first tarsometatarsal joint. The distally placed portal avoids injury to the insertion of the PL tendon at the base of the first metatarsal and medial cuneiform.…”

Section: Techniquementioning

confidence: 99%

Tendoscopy of Peroneus Longus in the Sole

Lui¹

2013

Foot Ankle Int.

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The long tendons in the sole of the foot are situated laterally and posteromedially and include the peroneus brevis, peroneus longus (PL), flexor digitorum longus, and flexor hallucis longus. 3 Tendoscopic techniques have already developed for access of the flexor hallucis longus 4,[9][10][11] and flexor digitorum longus 8 tendons in the sole.The peroneal tendons can be divided in 3 zones for tendoscopy. Zone 1 tendons consist of both PL and peroneus brevis tendons from the musculotendinous junction to the peroneal tubercle. The tendons have a common tendon sheath in this zone. Zone 1 tendoscopy was well developed and has been used for management of different problems of the tendons at this zone. 2,3,5,6,13 Zone 2 tendons have a separate tendon sheath at the level of the peroneal tubercle. Separate tendoscopy is required for the individual tendon sheath of this zone. 7 Zone 3 peroneal tendoscopy is endoscopy of the tendon sheath of the PL tendon into the sole of the foot. The technique of zone 3 peroneal tendoscopy is described below. TechniqueThe patient is placed in a supine, lateral, or prone position depending on any concomitant procedures needed. Putting the patient prone is the best position for this procedure. A thigh tourniquet is applied to provide a bloodless operative field. A 2.7-mm, 30-degree arthroscope is used for this procedure.Two plantar portals are needed for the zone 3 tendoscopy. The plantar-lateral portal is located just distal to the turn of the PL tendon around the cuboid, which is 1 to 1.5 cm proximal to the tip of the fifth metatarsal styloid. The portal should be plantar to the turning of the PL tendon at the cuboid tunnel and about 1 cm plantar to the plantar-lateral edge of the cuboid. At the cuboid level, the PL tendon contains a fibrocartilaginous or osseous sesamoid, which is held in place by strong soft tissue attachment at the proximal and dorsal parts of the cuboid tunnel. 3,12 The distally placed portal can avoid injury to the soft tissue attachment. Moreover, the PL tendon run dorsally toward the base of the first metatarsal; thus, a more plantarly placed lateral portal eases the passage of the instrument. If a more proximal zone peroneal tendoscopy is performed, the point of turning of the PL tendon around the cuboid can be determined arthroscopically before making the plantar lateral portal.The PL tendon inserts onto the tuberosity located at the inferolateral corner of the base of the first metatarsal, which is approximately 8 mm from the edge of the articular surface. 1 The plantar-medial portal is at the plantar-lateral side of the base of the first metatarsal, which is about 1 to 1.5 cm from the first tarsometatarsal joint. The distally placed portal avoids injury to the insertion of the PL tendon at the base of the first metatarsal and medial cuneiform. The portal track is oblique in the coronal plane and passes through the abductor hallucis muscle. The entry point is marked by a needle, which can be guided by the light of the scope through the plantar-lateral portal (F...

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“…In their anatomical radiographic study of the first metatarsal, Christman and Ly [6] found that the medial eminence can be viewed tangentially with the dorsoplantar projection. The eminence is isolated and appears as a small protuberance with the lateral oblique projection (medial oblique view) and it is superimposed on the head and neck with the medial oblique and lateral projections.…”

Section: Introductionmentioning

confidence: 99%

A Method for Measurement of the Hypertrophic First Metatarsal Medial Eminence on Foot Radiographs—A Reliability Study with Surgical Implications

Armanasco¹,

Briffa²,

Pang³

2014

JASMI

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Background: It has been suggested that hypertrophic eminence on the medial head of the first metatarsal is a component of the patho-anatomy of hallux valgus. However, research findings in this area are inconsistent, possibly due to differences in methods in identifying and measuring the medial eminence. To date, reliability of any method of measurement has not been reported. The purpose of this study was to determine the reliability of measurement of the medial eminence on medial oblique and dorsoplantar radiographs using a previously described geometric technique. Methods: To evaluate the reliability of a method of measurement of the medial eminence of the first metatarsal duplicate standardized dorsoplantar and medial oblique radiographs were taken of one foot of 15 subjects. The feet included both rectus feet and subjects with hallux valgus. The medial eminence was measured on the digital images using Inteleviewer 2.5 (Intelerad medical systems incorporated, Montreal, Quebec) software. Observer 1 measured one randomly selected image from each subject to determine inter-observer reliability. Observer 2 measured all images to determine the overall intraobserver reliability. Reliability was calculated using intra-class correlation coefficients (ICC). Results: The mean projection of the medial eminence ranged from 0.39 to 0.44 cm in both views. The ICCs were calculated for the dorsoplantar view and the 2 medial oblique view measures between observers. They ranged from 0.76 intra-rater and 0.86 interrater in the dorsoplantar view to 0.80 intra-rater and 0.90 inter-rater in the medial oblique view indicating good reliability in all measures. The average of the 4 oblique views also showed a high level of reliability with a coefficient of 0.96. Conclusions: The medial eminence can be reliably measured in the medial oblique and dorsoplantar view using the described technique. The medial * Corresponding author. P. S. Armanasco et al. 32oblique and the dorsoplantar views are valuable and reliable projections for visualising the dorso medial aspect of the first metatarsal.

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Radiographic anatomy of the first metatarsal

Cited by 7 publications

References 0 publications

Peroneus Longus Tendoscopy at the Sole: A Cadaveric Study

Peroneus Longus Tendoscopy at the Sole: A Cadaveric Study

Tendoscopy of Peroneus Longus in the Sole

A Method for Measurement of the Hypertrophic First Metatarsal Medial Eminence on Foot Radiographs—A Reliability Study with Surgical Implications

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